DR. KELLY MARIE GONZALES (NPI# 1417128687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417128687 |
| Entity Type | Individual |
| Full Name | DR. KELLY MARIE GONZALES |
| Credential | DDS |
| Practice Address |
1103 Rivery Blvd Ste. 140 Georgetown TX 78628-3034 |
| Mailing Address |
1103 Rivery Blvd Ste. 250, Pmc 157 Georgetown TX 78628-3034 |
| Practice Telephone | 9032883898 |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
22251 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194109702 | Kelly D Gonzales | Nurse Practitioner | 4282 Genesee Ave Ste 103, San Diego, CA 92117 | 2015-07-13 |
| 1770192841 | Kelly Gonzales | Behavior Technician | 8885 Rio San Diego Dr Ste 340, San Diego, CA 92108-1669 | 2020-07-24 |
| 1669887584 | Kelly Gonzales | Nurse Practitioner | 985330 Nebraska Medical Ctr, Omaha, NE 68198-5330 | 2014-06-30 |
| 1497088868 | Kelly Herzstein Gonzales | Counselor | 7225 N 1st St, Suite 101, Fresno, CA 93720-2986 | 2009-09-16 |
| 1184899874 | Kelly De Gonzales | Surgery | 150 N Jackson Ave, Suite 100, San Jose, CA 95116-1908 | 2008-04-24 |
| 1720188295 | Kelly Aileen Gonzales | Physician Assistant | 5207 Heritage Ave, Colleyville, TX 76034 | 2006-09-25 |
| Street Address |
1103 RIVERY BLVD STE. 140 |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78628-3034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629158209 | Randy S O Brien | Dentist | 1103 Rivery Blvd, Suite 300, Georgetown, TX 78628-3034 | 2006-10-17 |
| 1750616637 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 1103 Rivery Blvd, Ste 300, Georgetown, TX 78628-3034 | 2009-10-09 |
| 1780858688 | Bhavesh B. Bhakta | Dentist | 1103 Rivery Blvd, Suite 300, Georgetown, TX 78628-3034 | 2008-04-22 |
| 1801060660 | Kelly M. Gonzales, Dds, PC | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2008-04-14 |
| 1871793083 | Stephen Mark Meacham | Dentist | 1103 Rivery Blvd, 300, Georgetown, TX 78628-3034 | 2007-07-25 |
| 1588788970 | Alison Damarodas Campbell | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2007-03-19 |
| 1619021268 | Jeffrey Chad Fendley | Dentist | 1103 Rivery Blvd, Suite 300, Georgetown, TX 78628 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164079760 | Maegan Marissa Milliet | Student in an Organized Health Care Education/Training Program | 302 Rideg Run Dr, Georgetown, TX 78628 | 2019-08-20 |
| 1366918419 | Harold F. Adelman, M.d, Pllc | Clinic/Center | 3008 Dawn Drive, Suite #103, Georgetown, TX 78628 | 2018-10-16 |
| 1679085401 | Georgetown Emergency Physicians Pllc | Clinic/Center | 1210 W University Blvd, Georgetown, TX 78628 | 2017-11-02 |
| 1134631450 | Meredith Rollins Hatcher | Physician Assistant | 204 S Interstate I-35, Suite 103, Georgetown, TX 78628 | 2017-10-26 |
| 1588188304 | Wolf Ranch Dental Group, PC | Dentist | 1135 West University Avenue, Georgetown, TX 78628 | 2017-08-02 |
| 1982066528 | Imren Ozturk | Family Medicine | Arc Georgetown, 940 W University Ave Suite 101, Georgetown, TX 78628 | 2016-03-23 |
| 1093114100 | Della Davis | Hearing Instrument Specialist | 1013 W. University Ave, Suite 122, Georgetown, TX 78628 | 2014-08-14 |
| 1083988125 | Deann Reinshuttle | Audiologist-Hearing Aid Fitter | 3316 Williams Dr Ste 115, Georgetown, TX 78628 | 2012-03-07 |
| 1700195823 | Zeyad B Mughrabi | Dentist | 1615 Williams Dr, Georgetown, TX 78628 | 2010-10-07 |
| 1497071534 | Jeri Lynne Manhal | Counselor | 1618 Williams Dr., Suite 4, Georgetown, TX 78628 | 2010-04-14 |
| Find all providers in zip 78628 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366613978 | Travis Reed Hildebrand | Dentist | 4402 Williams Dr, Ste 106, Georgetown, TX 78628-1341 | 2008-03-22 |
| 1447331509 | Pediatric Dentistry of Georgetown, Pllc | Dentist | 101 Darby Dr Ste 101, Georgetown, KY 40324-8715 | 2006-10-17 |
| 1396835575 | Hamid Yazdi | Dentist | 9415 W State Highway 29, Georgetown, TX 78628-6914 | 2006-10-16 |
| 1497386049 | Kids Dentistree of Ky LLC | Dentist | 1508 Oxford Dr, Georgetown, KY 40324-9266 | 2020-02-03 |
| 1184909814 | Liberty Hill Pediatric Dentistry, Pa | Dentist | 9415 W State Highway 29, Georgetown, TX 78628-6914 | 2011-10-13 |
| 1801060660 | Kelly M. Gonzales, Dds, PC | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2008-04-14 |
| 1588836183 | Kenneth Seely Havard | Dentist | 4402 Williams Dr, Suite 106, Georgetown, TX 78628-1341 | 2008-03-24 |
| 1083807945 | Dentistry for Children | Dentist | 205 Champion Way, Suite 9, Georgetown, KY 40324-8862 | 2007-08-23 |
| 1588788970 | Alison Damarodas Campbell | Dentist | 1103 Rivery Blvd, Ste 140, Georgetown, TX 78628-3034 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647454 | Memorial Dentistry for Kids Pllc | Dentist | 14090 Memorial Dr, Houston, TX 77079-6848 | 2020-10-20 |
| 1497362651 | Munal Dental Pllc | Dentist | 2921 N Fm 1417 Ste 100, Sherman, TX 75092-3559 | 2020-09-30 |
| 1467069880 | Unique Kids Pediatric Dentistry, Pllc | Dentist | 22118 Market Place Dr Ste 500, New Caney, TX 77357-2165 | 2020-09-29 |
| 1104438092 | Sarah Al Kukash | Dentist | 2536 Amherst St Ste A, Houston, TX 77005-3207 | 2020-08-20 |
| 1295344679 | Bulverde Dental Specialist Pllc | Dentist | 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 | 2020-07-30 |
| 1174132559 | Previcare, Pllc | Dentist | 2006 W Campbell Rd Ste 300, Garland, TX 75044-2315 | 2020-07-30 |
| 1386252088 | Saba Saleem Tareen | Dentist | 1503 Royal Ln, Colleyville, TX 76034-5585 | 2020-07-19 |
| 1306454178 | Susan Roberts Pediatric Dentistry Pllc | Dentist | 5411 Basswood Blvd Ste 201, Fort Worth, TX 76137-4479 | 2020-07-17 |
| 1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
| 1316563497 | Woodlands Pediatric Dentistry PC | Dentist | 4850 W Panther Creek Dr Ste 102, The Woodlands, TX 77381-3595 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
| City | GEORGETOWN |
| Zip Code | 78628 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.